“OUCH!! MY FEET HURT!!”

HAVE YOUR FLIP FLOPS CAUSED YOUR PLANTAR FASCITIS?

Spring is finally here and many of us are becoming more active outside in the sunshine and warmer weather (hopefully!!). Our feet, which have become accustomed to our more sturdy and supportive rain boots and winter shoes, have been traded in for our summer sandals and flip flops. After beginning to wear those unsupportive pieces of foam which we term flip flops, some of us will subsequently wake up in the morning and stand up on our newly remodelled hard wood floors only to find a sharp pain has now developed on the bottom of our feet, even making it hard to walk initially. Chances are you may have developed Plantar Fasciitis.

Plantar Fasciitis is a painful condition caused by overuse of the plantar fascia or arch tendon of the foot. The Plantar Fascia is a broad, thick band of tissue that runs from under the heel to the front of the foot.

Plantar fasciitis can also be known as a heel spur although they are not strictly the same. A heel spur is a bony growth that occurs at the attachment of the plantar fascia to the heel bone (calcaneus). A heel spur can be present (through repetitive pulling of the plantar fascia) on a foot with no symptoms at all and a painful heel does not always have a heel spur present.

What Are the Common Causes of Plantar Fasciitis?

The most common cause of plantar fasciitis is very tight calf muscles which lead to prolonged and / or high velocity pronation of the foot. This in turn produces repetitive over-stretching of the plantar fascia leading to possible inflammation and thickening of the tendon. As the fascia thickens it loses flexibility and strength.

Some practitioners think overpronation can always be determined visually by the dropping and rolling in of the arch. This is not always the case. Sometimes it can only be seen with foot scans, especially if the patient has a high arched foot. See the article to the right about FootMaxx Scans.

Other causes include high arch or low arch feet (pes cavus / planus) and other biomechanical abnormalities including over supination which should be assessed by a chiropractor or podiatrist.

Excessive walking in footwear which does not provide adequate arch support has been attributed to a recent increase in plantar fascitis such as those stylish flip flops. In fact, the American Podiatry Association has recommended that the use of flip flops should be avoided entirely. Luckily for those who are flip flop die-hards, various shoe and orthotic manufacturers have come up with safe and supportive flip flops that are also stylish. (See the article to the right on FootMaxx Footwear.)

In addition, overweight individuals are more at risk of developing the condition due to the excess weight impacting on the foot.

How is Plantar Fasciitis Treated?

• Rest until it is not painful. It can be very difficult to rest the foot as most people will be on their feet during the day for work. By walking on the painful foot you are continually aggravating the injury and increasing inflammation.
• Apply ice or cold therapy to help reduce pain and inflammation.  Cold therapy can be applied regularly until symptoms have resolved.
• Stretching the plantar fascia is an important part of treatment and prevention.
• A plantar fasciitis night splint is an excellent product which is worn overnight and gently stretches the calf muscles and plantar fascia preventing it from tightening up overnight.

What Your Chiropractor can do:

• Recommend a natural anti-inflammatory
• Perform gait analysis to determine if you overpronate or oversupinate.
• Prescribe orthotics or insoles. An insole can restore normal foot biomechanics if overpronation is a problem.
• Apply sports massage techniques to reduce the tension in the plantar fascia and also stretch the calf muscles.
• X ray to see if there is any bone growth (heel spur). If present, will require special modifications to the custom foot orthotic.
• Recommend healthy footwear. Even if it is summer, there are healthier and more supportive choices of sandals and footwear. However, those cheap flat flip flops should really be avoided.

If you believe that you, or someone you know, could be suffering from pain or inflammation, call the office today to schedule an appointment to see what treatment options are available to you.

~Dr. Gertz

When I first graduated from Chiropractic College, my dad with his usual helpful wisdom, suggested to me that I should move to Victoria and set up practice. “There’s lots of retired people there, and seniors love Chiropractors”, he proclaimed. What is it that seniors know that a lot of their younger counterparts seem to miss? And how exactly does regular chiropractic care help them?

A three year study published in Topics in Clinical Chiropractic in 1996 examined senior citizens over the age of 75 years of age and revealed that seniors who receive regular chiropractic care experienced the following:

1. Chiropractic patients spend 15% less time in nursing homes and 21% less time in hospitals than the non-chiropractic patients

• 2. Report “better overall health” on quality of life surveys (87% of seniors under chiropractic care described their health as “excellent” or “good”, compared to only 65% of non-chiropractic patients)

  3. Have fewer chronic conditions

  4. Were less likely to utilize prescription drugs than non-chiropractic patients

  5. Were more likely to exercise vigorously and be active in the community

As the population ages, more people more people are consulting doctors of chiropractic, especially in their later years. As we live longer there are growing concerns about over-medication and the side effects of combining various prescription drugs. Safe natural chiropractic care is growing in popularity.  Restoring proper nerve and spinal function can help improve mobility, vitality, and endurance, and therefore the quality of your life.

Is chiropractic care only good for seniors? As I once heard an investment banker speak about savings plans, “the best time to start saving would have been 20 years ago, but the second best time is now.”  The same goes for your health. Experiencing the health benefits of chiropractic care now will also provide benefits for your enjoyment of your life in your later years.

Most Frequent Benefits Regular Chiropractic Care provides for Seniors

1. Pain Relief

Chiropractic care is one of the most effective and safest forms of health care to treat pain due to spinal related conditions. Chiropractic is so effective because most causes of spinal disorders are related to abnormalities of the spine and the surrounding soft tissue structures.

2. Increased Range of Motion of the Spine and Extremities

Chiropractic care has been shown repeatedly to increase not only the range of motion of the spine but also in the extremities. Increasing a person’s range of motion can positively and drastically affect lives in many ways. For some, an increased range of motion means being able to bend down to pick up their grandchildren. For others, it means they can garden without pain or get an extra 40 yards of distance out of their driver on the golf course. In many cases, an increase in range of motion immediately follows chiropractic adjustments. This is one of the reasons why many top professional sporting teams have team chiropractors.

3. Increased Balance and Coordination

Many problems in balance and coordination in the aging population have been shown to come from injury or degenerative changes to the cervical spine (neck region). Structures known as mechanoreceptors are located in the posterior (back) joints of the cervical spine and are responsible for providing the brain with essential information important for balance and coordination.

4. Decreased Joint Degeneration

A subluxated (misaligned) spine is much like a misaligned wheel on an automobile. This misalignment will cause the spine (and the wheel) to wear out prematurely. Since all moving parts will eventually wear down over time, it is very important to get your spine aligned periodically. Chiropractic care decreases spinal degeneration and other arthritic changes by normalizing the spinal alignment and reducing spinal stress.

5. Increased Health and Well-Being

We commonly ask our patients what changes they notice once they are put of pain. Here are some regular responses we hear every day:
I feel great!

I can sleep through the night!

Now I can play in the garden!

I have so much energy!

Life is worth living now!

Yes, chiropractic is far more than mere pain relief. Feeling good, staying healthy and doing the things that make us happy are what keeps us looking forward to each new day. Regular chiropractic care increase the quality of life and increase health and well being.

6. Decreased Incidence of Falling

Injuries due to falling are extremely common in the elderly population. According to the Centers for Disease Control and Prevention (CDC), falls are responsible for 90% of the 850,000 bone fractures which occur annually among Americans past the age of 65. Chiropractors reduce the risk of falls by normalizing the mechanoreceptors of the cervical spine by administering chiropractic adjustments. They also prescribe stretching and exercise programs to increase strength, flexibility, mobility, balance and coordination.

Start with calling our office to schedule yourself, or someone you know, in for a check up appointment to see what treatment options are available to you.

Dr. Gertz

Some of us may still remember the days when our Grandmother used to feed us Cod liver oil every morning. “Have some. It’s good for you!”  Trying hard to not vomit it back up, we did our best to down the fishy tasting oil and immediately wash it down with our morning orange juice. Oh, how we dreaded that morning routine. It now seems that Grandma may have been onto something.

Cod liver oil is rich in Omega 3 oils and it has been determined that the typical North American diet is almost devoid of these types of fats, with the exception of fish. Researchers believe that about 60% of Americans are deficient in Omega 3 fatty acids and about 20% have so little that test methods cannot even detect any in their blood. Since our childhood days, we have learned a lot more about the importance of these oils. In fact, over 2000 scientific studies have demonstrated the wide range of problems associated with deficiencies in Omega-3 fat.

Why are we so deficient today as opposed to decades or even hundreds of years ago?

In our ancestors era, a small amount of one type the Omega-3 fats was converted in part from nuts, seeds and the many vegetables we ate in our bodies. Today, our diet is sorely deficient in such vegetables and even the vegetables we do eat are grown with different farming methods, harvesting times, and grown in deficient soil (the subject of which we will not explore here) and as a result have less nutritional value. The Canada food guide, which many argue is still too low in its vegetable requirements, suggests 7 daily servings per day of vegetables which are best served raw or steamed.  Through my many nutritional inquiries of patients, easily 95% of people sheepishly admit to less than half of that amount.

The majority of Omega-3 fats that we require are only found from animal sources. Historically, these animals were undomesticated and “free range” (eating a healthy diet of plants as they grazed) and containing sufficient Omega-3 fats (because they were healthier). Today, these animals are domesticated and fed a diet of cereal grains and corn to “fatten” them up. Unfortunately, the type of fat created from this diet is not the Omega-3 variety, but a more harmful type of fat which is linked to cardiovascular disease and cancer. Not only does the meat from domesticated animals consist of five times the amount of fat than wild or “free range” meat, and contain an unhealthy type of fat, the healthy Omega-3 fats are almost undetectable in certain domesticated animals such as cows.

The main source of Omega-3 that can be found in our diets is from fish. Of course, the issue with eating large amounts of fish is the contaminants found in the fish such as Mercury. In order to eat sufficient levels of Omega-3, one would have to consume fish on a daily basis and this is not generally advisable with specific types of fish due to these contaminants.  This is where supplementation of Omega-3 fats is highly advisable.

What makes a good supplement?

A good quality Omega-3 supplement should consist of a high concentration of EPA and DHA (the two desired types of Omega-3 fats).  The source of these fats should be from specific types of fish known to be lower in potential contaminants such as smaller fish where the bioaccumulation of toxins is less. It should have gone through a specific process to remove those contaminants.  It should be independently tested for quality and purity, and it should be packaged specifically to avoid spoilage and oxidation.  (Too bad Grandma, the ol’ Cod liver oil just doesn’t cut it anymore!) As with all supplements, you get what you pay for and I can’t emphasize this strong enough. This is why the only Omega-3 supplements that we have available for you in our clinic are ranked the highest in the world.

What are some of the symptoms of Omega-3 deficiency? And why are they so important in our bodies?

Our typical North American diet today consists of a diet high in Omega-6 fats. Western cultures over-consume omega-6 fats (from vegetable oils, processed foods, grains and domesticated meats). Although a certain amount of Omega-6 is a necessary component to the human diet, the ratio of Omega-6 to Omega-3 should be about 2:1 or 1:1.  The Canadian diet has been estimated to be 15:1 (as high as 22:1  !!) and a large body of research suggest that excess omega-6 and a relative deficiency of omega-3 is a nutritional imbalance that contributes to pain and inflammation.  In a state of Omega-3 deficiency and with an imbalance of the omega-6 to omega-3 ratio, this creates an ongoing state of inflammation in the body which is extremely harmful. This has been tied to many conditions including the following:  cancer, coronary arterial disease, strokes, inflammatory diseases, skin conditions (dry skin, eczema), arthritis, weight gain and diabetes.

Omega-3 inhibits the conversion of this specific type of Omega-6 along the inflammatory pathway. Therefore it has an anti-inflammatory role in the body in preventing the above conditions. It is also important in reducing inflammation involved in back pain, joint pain, arthritis and soft tissue injuries. In fact, it is extremely important to address the nutritional state of an individual when dealing with these conditions along with chiropractic care. Simply taking a pharmaceutical drug (with all the potential for known serious toxic side effects) and ignoring the underlying musculoskeletal condition and nutritional imbalance is nothing short of negligence in my opinion. Remember, conservative care to restore you to your body’s natural state is always the best method first tried as it will always move and restore you to a greater level of health.  Drugs and surgery should only be applied in cases of emergency or if conservative methods are not sufficient.

The human brain is made up of approximately 60% polyunsaturated fats of which 94% is Omega-3 fat. Every time we use our brains for new thoughts and learning, new neural connections are made. We require Omega-3 fats to make these new connections as well as receptors on these cells. A chronic deficiency of Omega-3 fats, especially in children, whose brains are still developing, can result in problems concentrating, depression, anxiety, and ADD. Studies have shown that there may be a direct connection between the amount of Omega-3 fatty acids in your diet, the number synaptic connections with your neurons and your ability to learn.

There are many other roles that Omega-3’s play in the body from regulating gene expression to decreasing the clotting factors of blood, which can lead to the reduction of strokes. There is a tremendous volume of research to show the importance of Omega-3’s in our normal regular body functioning and that a deficiency of it can contribute to a variety of ailments. What we are is certainly a consequence of what we eat.

If you would like any more information or discuss Omega-3 supplementation specific to your needs, I would be more than happy to chat at our next visit!

Dr. Gertz

We’re turning up the heat.

Aww….. my most favorite of the therapeutic applications. Let’s begin with why you would want to use heat. It draws blood to the area (it’s like there’s a party in your soft tissues and everyone is invited!). Blood brings oxygen and nutrients to your tissues and flushes out all the waste you don’t need.

Is there anything I shouldn’t use heat for?

Do not put heat on an area that is puffy and swollen. There’s already enough going on at that point. Adding more blood is NOT going to help you. To check if an area is experiencing swelling (aka inflammation) compare to another part of your body. For example, if one leg is twice the size as the other then that’s a good sign it’s swollen. If heat is radiating out from somewhere, then that’s another one. Also if the skin in the area is that reddish/pink color, it may also be indicating inflammation is present.

What can I use as a heat source?

There are so many options: electric pads (my least favorite unless they have a timer), a microwaveable bean/grain bag, a hot water bottle, Epsom salt bath, even taking a hot shower works.

How do I know if it’s too hot?

Easy….Oww!… it burns to the immediate touch….ok it’s too hot.

How long do I keep it on?

Thank you so much for asking. Many people have more than likely heard me repeat myself about 100 times saying “please only keep it on for 10-15 minutes!”. Why would I want to limit such a lovely experience? Allow me to point out that like the turkey you may have had in December we too are fleshy creatures and yes we too can cook. So please don’t be a cooked turkey. A heat source should NEVER….I repeat NEVER be left on for more than 20 minutes. As a massage therapist, the worst thing I can hear is “oops I fell asleep with the heating pad on again last night”. This is why I’m not a fan of the electric heating pads.

When should heat be used?

When an injury is over a week old and no inflammation is present. Another situation when heat is useful is for chronic complaints. Such as tight muscles that never seem to want to relax. Sometimes a certain area can have a decrease blood flow due to restrictions or scar tissue. Heat may help to loosen things up and allow circulation to get to deprived tissue.

***Always ask your healthcare practitioner if you have any questions about using heat or cold. If you have a pre-existing disorder you may want to verify before laying on the heat.***

Again it is important to listen to your body. If it’s too hot please take it off….the heating pad that is!

Cathy Charbonneau, RMT

Like millions of Canadians per year, you may have originally come into your Chiropractors office with an injury. It was diagnosed, and treated and eventually the pain went away. Some of you continued beyond that initial intensive care to more corrective care and actually made some progress in dealing with the actual underlying issue whether it was faulty biomechanics, a misalignment, or perhaps some damage to your spine from a long standing injury. Now you have been recommended that you should continue on with maintenance care. In our office, approximately 60% of you will continue with maintenance care. Why? For most of us, much like regular dental check-ups, taking vitamins, and exercising, it inherently just makes sense. After all what constitutes a healthy spine? A health spine is simply put, one that is flexible and strong, and protects the spinal cord and nerves adequately. Our spines are subject to stresses 24 hours per day unlike your teeth, so stiffness and misalignments can and do occur over time in most of us. A really important key to remember is that the spine protects our nervous system. So a healthy spine = a healthy nervous system = a healthy body. Problems in the spine can build up over time, silently, without any symptoms, which if left uncorrected can create damage to the spine over time. It makes sense to take regular care of your spine. Most of us get that concept.

After a while and for a few of us, the question inevitably comes “well, I feel fine now – so why do I still need maintenance treatment?”  Really, it is no different from asking, “I’m not overweight, so why should I keep exercising?”, or “I don’t have a toothache so why should I go to a dentist?”  Like a lot of things, when the initial symptoms that drove you to our office, such as pain or stiffness, disappear, it is “out-of-sight, out-of-mind”.   We know it makes sense, but if we are no longer in pain, how do we really know that our health efforts are working? – whether that is regular chiropractic treatments, brushing our teeth, taking vitamins, or exercising. For some of us, the effects of regular chiropractic care are fairly immediate – we notice we think clearer, have more energy, sleep better at night, get sick less often, our sports performance is better, stronger, our mood is better, and we tend to make better health choices such as eating better.

Once we reach higher levels of health, the effects of regular care become less dramatic. After all, we are maintaining a higher level of health now. So we begin to question the methods that got us to that level to begin with. For instance, I hear quite often, “I feel healthy, so how do I know that vitamins are still working?”  We need a bit more reassurance that our time, money and effort spent on our health is really worth it.  We know it makes sense but it’s tempting to start to let some of our efforts go. This is where the research comes in.

What does the research show? The research from all areas of science – medical journals, physiology, neurology, biomechanics, immunology, anatomy, etc. show that having a flexible and strong spine (a “healthy” spine) can produce healthy effects not just in the spine but throughout our bodies. This can include healthy effects on our organs such as our bowels and lungs, our immune system, our mental state, and our entire neurophysiology!

Here are just a few recent interesting studies:

• From the Journal of Spine, a 2011 article by two medical doctors concluded that for chronic suffers of low back pain, “those patients who maintained spinal manipulation treatment maintained their good results while those patients who did not maintain returned to their pre-treatment”.  To obtain long-term benefit, this study suggests maintenance adjustments after the initial intensive manipulative therapy.
• A large research study of over 17,000 people showed that regular wellness chiropractic care reduced work loss by up to 75%.
• In a study by Professor F Splendori – Chiropractic therapeutic effectiveness, social importance, incidence on absence from work and hospitalization, Italy, 1988, it was concluded that regular Chiropractic care improves productivity and overall quality of life, and those under regular care consistently make healthier life choices.
• The first conventional HMO in the US to use chiropractors as a primary care physician found that after just two years of utilizing chiropractors, their hospitalizations were reduced by 80%, outpatient surgery was reduced by 85%, and prescription drug use was reduced by 56%.

A three year study published in Topics in Clinical Chiropractic in 1996 examined senior citizens over the age of 75 years of age and revealed that seniors who receive regular chiropractic care experienced the following:

• Chiropractic patients spend 15% less time in nursing homes and 21% less time in hospitals than the non-chiropractic patients
• Report “better overall health” on quality of life surveys (87% of seniors under chiropractic care described their health as “excellent” or “good”, compared to only 65% of non-chiropractic patients)
• Have fewer chronic conditions
• Were less likely to utilize prescription drugs than non-chiropractic patients
• Were more likely to exercise vigorously and be active in the community

The above are some of the multitude of research studies on maintenance care. One area of particular interest to me is the research on the effectiveness of regular chiropractic care on depression, anxiety and mental function which I will highlight in a future newsletter.

For now, I would give you one piece of advice – Get Adjusted Regularly!

In Health, Dr. Gertz

Sometimes the questions I hear over and over are the most simple. At least they are to me but of course they aren’t for most people. Why would you know unless someone told you?
Cold vs. Heat Part 1
The deal with using ice…Ice is great for acute injuries. What does acute mean? Acute is when something has just occurred in the last 3 days or is flared up. For example: Yesterday, you played soccer and rolled an ankle. Today (or even immediately afterwards) you experience pain, swelling, redness and heat at the area.
Oh no!! What should I do?
In this situation you should elevate and ice the area. Elevation consists of simply bringing the area in question (i.e. the ankle) above your heart….head stand???? No!!!! Take a breather and lie down on your sofa with a couple pillows under your feet.
Then what???
Ice.
Things to keep in mind when icing. There should always be some form of barrier between the ice pack and your skin, like a towel. Why? Many people don’t
realize you can actual burn the area…..hello frostbite….hello not so good times.
What kind of ice pack should I use? I often (ok almost always) recommend a bag of peas (I won’t judge if it’s carrots or corn). The reason is because it will easily conform to the area being iced. Also it’s cheap and reminds you to eat your veggies (side note please don’t use, thaw, use, thaw, use than eat…..yuck).
How long should I keep it on for?
What an excellent question. First, let’s go over what you will experience while using ice.
Step 1=cold…..brrrr
Step 2=burning……it’s ok, it’s a good burn
Step3=ache…..ok I’m not sure how to make that sound like a positive
Step4=numb…..NEVER! EVER! allow an ice pack to sit for a long period of time on an area once it is numb!!!! Typically I tell people to leave it for about 5 to 8 minutes than to remove it for about 5 minutes and repeat. Yes it is safe to leave it on longer, as long as you followthe 4 steps above. Some suggest 20 to 30 minutes ***MAXIMUM*** of ice then allowing at least 1.5 to 2 hours between so the area can go back to its regular temperature before repeating. Feel it out and see what works for you. Everyone is different so listen to your body!!!
If you have any questions please do not hesitate to ask myself or any healthcare practitioner who is helping you along your path to wellness.

Cathy Charbonneau, RMT

An excerpt from The Power of Discipline 
by Brian Tracy

Your ability to discipline yourself to set clear goals, and then to work toward them every day, will do more to guarantee your success than any other single factor.

It seems that only 3% of adults have written goals and plans, and they earn more than the other 97% put together.

Why is this? The simplest answer is that, if you have a clear goal and a plan to achieve it, your focus is fixed on a set course of action. Instead of becoming sidetracked by distractions and diversions, your time is focused on a straight line from start to finish. This is why people with goals accomplish so much more than people without them.

The tragedy is that everyone thinks they already have goals. But what they really have are hopes and wishes.

A wish has been defined as a “goal with no energy behind it.” Hope is not a strategy.

Goals that are not written down and developed into plans are like bullets without powder in the cartridge. People with unwritten goals go through life shooting blanks. Because they think they already have goals, they never engage in the hard, disciplined effort of goal setting, the master skill of success.

USA Today reported on a study a couple of years ago. First, researchers selected people who made New Year’s resolutions. Then they divided these people into two categories: those who made New Year’s resolutions and wrote them down, and those who made New Year’s resolutions, but neglected to write them down.

Twelve months later, they followed up on the respondents in this study. What they found was astonishing! Of the people who made New Year’s resolutions but neglected to write them down, only 4% actually followed through on their resolutions.

However, among the group that took a few minutes to record their New Year’s resolutions, 44% followed through on them. This difference of more than 1100% proves the simple act of crystallizing resolutions or goals on paper increases likelihood of success.

In my experience (Brian Tracey) of working with several million people over the past twenty-five years, the disciplined act of setting goals, making plans for their accomplishments, and then working on them daily, increases the likelihood of achieving your goals by ten times, or 1000%.

This does not mean that goal setting guarantees success, only that it increases the probabilities of success by ten times. These are very good odds to have working in your favor.

Best wishes in 2012,

 Dr. G